LTC/RCF billing codes

LTC/RCF billing codes

Physicians who care for patients in provincial long-term care (LTC) and residential care facilities (RCF) have a variety of fee code options available to them when billing for care delivered.

For quick reference, this chart briefly compares some of the key parameters for billing these codes.

LTC/RCF billing codeMSUIn-person or virtualMultiplesDocumentationPremiums

Prolonged Nursing Home visits

03.03 VIST location = NRHM

21.3

After 24 minutes, claim multiples:

(MU =17 MSU/15 minutes)

In-person

A portion of time must be spent with the patient

In-person

A portion of time must be spent with the patient

Start and stop times after 24 minutes
  • TI=EVNT
  • TI=EVMD
  • TI=MDNT
  • DA=RGE, TI=AMMN
  • DA=RE1, NEW

Nursing Home Telephone Patient Assessment with Regulated Nursing Professional

NHTA1

16.5Telephone onlyNoInclude a medical reason/history of presenting illness, an assessment, an evaluation of relevant body systems, a working diagnosis and a planTI=GPEW premium

Allied Health Care Provider to Physician

AHCP1

7.5Virtual (includes by fax or email)NoText required about the intervention if a visit occurred the same dayNo

Nursing Home Chart Review

03.03 RO = NHCR

11.5 for groups of three telephone calls/faxes or emails per day/patient Both (includes by fax or email)No, however, claim each additional group of threeDocument visit well to avoid confusionTI=GPEW premium

Always remember to document well to avoid confusion about the visit and remember to record start and stop times for prolonged visits when multiples are billed.

See more information about these codes in the March 2026 issue of doctorsNS magazine.

It is important to review the description and billing guidelines for these fees to ensure correct billing and documentation. Questions? Contact MSI_Assessment@medavie.bluecross.ca before billing.